title: Detection and measurement of artificial periapical lesions by cone-beam computed tomography.
abstract: OBJECTIVE
  To test the ability of periapical radiography (PA) and cone-beam computed tomography (CBCT) to determine the presence/absence of periapical lesions and examine the reliability of volumetric measurements of periapical lesions on CBCT scans.
  
  
  METHODS
  After tooth extractions in human mandibles, bone defects were cut at the base of extraction sockets to mimic periapical bone lesions. The teeth were then returned into the extraction sockets. Sixty-three roots of anterior teeth, premolars and molars with artificial periapical lesions and 37 roots without lesions were examined with PA and CBCT. Presence/absence of periapical lesion was noted. The CBCT-based volume of each lesion (Vct) was measured using Amira software 5.4 (Visage Imaging GmbH, Berlin, Germany). A replica of each lesion was created using silicone impression material, and the volume of the replica was measured using a water displacement method, representing the physical volume of the lesion (Vp). Regression analysis was used to test the correlation between the Vp and Vct values.
  
  
  RESULTS
  The positive and negative predictive values and accuracy for CBCT in diagnosing periapical lesions were all 1, compared with 1, 0.64 and 0.79 for PA diagnosis. Twenty-one (33%) lesions were undetected by PA. The Vp (21.5 ± 11.0 mm(3) ) and Vct (21.4 ± 11.5 mm(3) ) values of 63 lesions were highly correlated (R(2) = 96.9%, P < 0.001).
  
  
  CONCLUSIONS
  Cone-beam computed tomography is more accurate than PA in diagnosing periapical lesions associated with mandibular teeth. The volumes of artificial mandibular periapical lesions were accurately measured with CBCT data.
authors.affiliation: Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China.
authors.forename: Y-H
authors.initials: YH
authors.lastname: Liang
authors.forename: L
authors.initials: L
authors.lastname: Jiang
authors.forename: X-J
authors.initials: XJ
authors.lastname: Gao
authors.forename: H
authors.initials: H
authors.lastname: Shemesh
authors.forename: P R
authors.initials: PR
authors.lastname: Wesselink
authors.forename: M-K
authors.initials: MK
authors.lastname: Wu
mesh_terms: D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging*; D054893:Cone-Beam Computed Tomography; D006801:Humans; D066298:In Vitro Techniques; D008334:Mandible / Q000000981:diagnostic imaging*; D010483:Periapical Diseases / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D014081:Tooth Extraction; D014092:Tooth Root / Q000000981:diagnostic imaging*
keywords: artificial periapical lesion; cone-beam computed tomography; periapical radiography; volumetric measurements